MEDICARE: ADMINISTRATIVE SUPPORT SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1669884839
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADMINISTRATIVE SUPPORT SERVICES LLC

Provider Business Mailing Address
First Line	:	335 E LINTON BLVD
Second Line	:	B14-2015
City	:	DELRAY BEACH
State	:	FL
Zip	:	33483-5023
Country	:	US
Telephone Number	:	954-200-6989
Fax Number	:

Provider Business Practice Location Address
First Line	:	335 E LINTON BLVD
Second Line	:	B14-2015
City	:	DELRAY BEACH
State	:	FL
Zip	:	33483-5023
Country	:	US
Telephone Number	:	954-200-6989
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MRS. ANY PARRA
Credential	:
Telephone Number	:	954-200-6989

Provider Enumeration Date	:	05/22/2014
Last Update Date	:	05/22/2014

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